Abilify- Stanford Clinic Patients

[leokitten]

Hyperprolactinemia with a chance of Amenorrhea, oligomenorrhea, galactorrhoea, gynecomastia, infertility.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124876/

Here are Extrapyramidal side-effects of low-dose aripiprazole. No complete recovery.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750315/

Here are Two Case Reports of rapid onset Akathisia with low dose Aripiprazole
https://www.researchgate.net/public..._with_low_dose_Aripiprazole-_Two_Case_Reports

I’ve reviewed these four case reports and three of the cases were due to combination fluoxetine and aripiprazole, because fluoxetine inhibits one of the two liver CYPs that metabolize aripiprazole, thus resulting in very much higher levels of aripiprazole than they were dosed.

In addition, all cases reports were given 5 or 10mg aripiprazole, which is not as low a dose as for ME.

The middle case report (Abilify and lorazepam) the patient did make a complete recovery, if I’m reading this correctly.

Im not saying there aren’t other reports of bad situations, just clarifying these four.

One very important lesson to everyone: if you want to trial Abilify, make sure to diligently check that any other drugs you are taking don’t inhibit metabolism of Abilify! Or on the other not dangerous side, make sure you aren’t taking drugs that increase the metabolism of Abilify, then it just won’t work.

 

[Badpack]

Well abilifys half-life is 75h. And no one over takes drug concentration rates during treatments anymore. So i wouldnt be supprised if the concentration in Cfs ppl are way higher than in "normal" psychiatric patients because of the disturbed metabolism. As many patients report that a lot of drugs are needed in way lower doses. So maybe 2-4mg translates to 5-10mg in the end anyway. Just a guess though.

 

[leokitten]

Well abilifys half-life is 75h. And no one over takes drug concentration rates during treatments anymore. So i wouldnt be supprised if the concentration in Cfs ppl are way higher than in "normal" psychiatric patients because of the disturbed metabolism. As many patients report that a lot of drugs are needed in way lower doses. So maybe 2-4mg translates to 5-10mg in the end anyway. Just a guess though.

Its not a simple calculation, but regardless of the half-life of a drug, if you are taking the same dosage every day it will eventually reach a specific steady state concentration in the body (of course a somewhat different steady state concentration for the same dosage depending on age, metabolism, excretion, etc)

So in the same person 2mg per day will definitely be a lower steady state concentration than 5 or 10mg per day.

Half-life just determines how often you have to dose to reach the steady state without it going up and down.

 

[sometexan84]

@hmnr asg clever avatar

 

[YippeeKi YOW !!]

To add to our discussion regarding combining celecoxib or etoricoxib (COX-2 inhibitors) with Abilify and potential synergistic effects, possibly related to further reducing neuroinflammation.

Celecoxib might not be a good choice. It’s a P450, 2D6 isozyme inhibitor which would have an effect on any of its substrates, Abilify being one.

Abilify metabolizes thru CYP2D6 and CYP3A4 and there are numerous other medications and even foods that can act as inducers or inhibitors.

An INDUCER is any substance or medication that increases an isozyme’s ability to metabolize a substrate, meaning that it will move thru your system too fast and reduce the amount of that medication too quickly. An INHIBITOR will prevent or seriously slow an isozyme’s ability to metabolize a substrate, which will keep too much of it in your system for too long.

Either way, it will alter the amount, action, and effect of any given medication in ways that might be less than optimal in terms of treatment outcomes.

 

[leokitten]

Celecoxib might not be a good choice. It’s a P450, 2D6 isozyme inhibitor which would have an effect on any of its substrates, Abilify being one.

Abilify metabolizes thru CYP2D6 and CYP3A4 and there are numerous other medications and even foods that can act as inducers or inhibitors.

Good point, I’ve read people taking both keep their Abilify dosage really low <1 mg/day at first and see how it goes.

With etoricoxib and aripiprazole there aren’t any CYP interactions. Important note is that etoricoxib is primarily metabolized by CYP3A4 which is one of the enzymes which metabolize aripiprazole, but it doesn’t inhibit the enzyme in any way, so otherwise just important to not eat foods which alter CYP3A4 activity.

Clinical pharmacokinetic and pharmacodynamic profile of etoricoxib

 

[YippeeKi YOW !!]

so otherwise just important to not eat foods which alter CYP3A4 activity.

Grapefruit, and I think starfruit. Inhibitors.

 

[stefanosstef]

Neuroprotective effects of the second generation antipsychotics, Chen et al. Schizophr Res, 2019

Systematic review of 24 studies looking at first gen (FGA) and second gen (SGA, atypical) antipsychotics. Multiple studies found evidence of neuroprotection with Abilify and other SGAs, though they were in vitro studies. FGAs either showed no protection or were actually found to be neurotoxic.

Pramipexole, my love as you've all figured out, has similar neuroprotective effects:

• Neuroprotection of pramipexole in UPS impairment induced animal model of Parkinson's disease
• Neuroprotection by pramipexole against dopamine- and levodopa-induced cytotoxicity
• Novel neuroprotective mechanisms of pramipexole, an anti-Parkinson drug, against endogenous dopamine-mediated excitotoxicity
• Low dose pramipexole is neuroprotective in the MPTP mouse model of Parkinson's disease, and downregulates the dopamine transporter via the D3 receptor
• Antioxidant property of pramipexole independent of dopamine receptor activation in neuroprotection
• Nrf2/HO-1 mediates the neuroprotective effects of pramipexole by attenuating oxidative damage and mitochondrial perturbation after traumatic brain injury in rats

The only thing holding me up so far is it won’t be worth for me and my severity level to trial Abilify if it turns out to last only a few months before fading. If it lasts more than a year in some people or with combo cox-2 inhibitors or LDN then that’s a different story, more than a year would be great and I might pull the trigger.

I’m not severe, I fluctuate between moderate and mild-to-moderate, and bedridden during crashes and recovery from crashes, which have been lasting longer and longer over the years as I’ve been slowly deteriorating due to work and constant overexertion. It’s not going to make much difference in my QOL if it only causes improvements for a couple months.

Again, pramipexole ( ), which I consider to work with a mechanism very similar to low dose abilify, has worked consistently for me with no reduction of effects or tolerance for at least 3 months.I haven't tested it for longer but I will soon knowl

I really wonder whether something like elamipretide, which targets mitochondrial myopathies and diseases with mitochondrial dysfunction (eg heart failure), will do anything for ME. I guess if there aren’t any super high risk side effects then why not trial it.

All the ME metabolomics and mitochondrial research to date hasn’t found anything abnormal with the functioning of our mitochondria except for this paper I believe:

Honestly the various ME metabolomics and mitochondrial research papers have some similar but also some conflicting conclusions.

There are a handful of CFS patients that are currently taking SS-31 at dosages ranging from 5mg to 50mg per day.Unfortunately the results aren't very positive so far but it may need some time.

 

[Chelby]

This also made me think that if there is such significant chronic microglial activation, release of proinflammatory cytokines, and neuroinflammation in ME then why aren’t we seeing significant neurodegeneration and brain atrophy in MRIs of pwME?

I had a Neuroquant brain atrophy MRI done recently which showed my entorhinal cortex was in the first percentile of volume compared to other people my age. Couple other areas were also under 5th percentile. Total volume 35th percentile.

Almost whole left side of my brain was smaller then right and it came up out of usual parameters for Neuroquant (but not significant enough to show on standard MRI)

Looking this up I see entorhinal complex atrophy is associated w schizophrenia, TBI and is the first area to atrophy in Alzheimer's. I'm 23.

Wonder if this is ME related. ME runs in my family, no schizophrenia. I'm just a pt so I don't know if these results a particularly abnormal or interesting.

 

[YippeeKi YOW !!]

Not sure where discussions about Abilify went, the last 26 entries have been about multiple other treatment possibilities .... I think the last mention of Abilify was on page 19 ...

They're all interesting and relevant to possibly treating the effects of this crappy little ring-worm of an illness, and should definitely be available for consideration by members but should be moved to another dedicated thread .....

This thread is about Abilify, no ???

 

[hmnr asg]

Not sure where discussions about Abilify went, the last 26 entries have been about multiple other treatment possibilities .... I think the last mention of Abilify was on page 19 ...

They're all interesting and relevant to possibly treating the effects of this crappy little ring-worm of an illness, and should definitely be available for consideration by members but should be moved to another dedicated thread .....

This thread is about Abilify, no ???

Unlike threads on abilify, the ones on ADHD medication like Ritalin rarely get sidetracked.

 

[SueJohnPat]

Still doing well with ability. Ran an ad on Facebook to sell excess furniture. I am replying to responses and actually have a sale today. I have been meaning to do this for a year. Also went to supermarket put stuff away , mailed a birthday gift to a friend . Weird it is like I am waking up a little . Went away for the weekend with a girlfriend. I did not have to take a nap ! Hope it continues.

 

[Mary]

THIS THREAD VEERED OFF-TOPIC INTO SEVERAL DIFFERENT DIRECTIONS. PLEASE STICK TO THE TOPIC OF ABILIFY AND ME/CFS. POSTS FROM THIS THREAD HAVE BEEN MOVED TO THREE DIFFERENT THREADS. IF ANY OF YOU THINK YOUR POST SHOULD HAVE BEEN MOVED ELSEWHERE, LET US KNOW.

HERE ARE THE THREADS WHERE POSTS HAVE BEEN MOVED TO:

Drug treatments and combos for ME/CFS, mitochondrial protection and toxicity

Tapering off of Cymbalta, Celexa

Promising Mitochondrial Peptides: SS-31 / Elamipretide + MOTS-c and Humanin

IF THIS THREAD VEERS OFF-TOPIC AGAIN, PLEASE REPORT IT IMMEDIATELY. IT TOOK A GREAT DEAL OF TIME TRYING TO SORT OUT ALL THE VARIOUS TOPICS WHICH POPPED UP HERE. ITS NOT OKAY TO START DISCUSSING RANDOM THINGS IN A THREAD IF DISCUSSION ABOUT THE THREAD TOPIC HAS STOPPED. START A NEW THREAD FOR A NEW TOPIC IF NEEDED.

 

[choochoo]

Still doing well with ability. Ran an ad on Facebook to sell excess furniture. I am replying to responses and actually have a sale today. I have been meaning to do this for a year. Also went to supermarket put stuff away , mailed a birthday gift to a friend . Weird it is like I am waking up a little . Went away for the weekend with a girlfriend. I did not have to take a nap ! Hope it continues.

Great news. What dose are you taking and how long?

 

[andyguitar]

Still doing well with ability

Do you get the feeling that it's like a switch has been turned on?

 

[SueJohnPat]

Do you get the feeling that it's like a switch has been turned on?

Totally . Like my brain went from neutral to drive!

 

[andyguitar]

Ah ha! Something that gets a mention from time to time here is people saying they "felt normal for a while" Might only be minutes or a couple of hours but it does happen. If you are looking for the elusive switch @Wishful this might be it.

 

[YippeeKi YOW !!]

Totally . Like my brain went from neutral to drive!

That's terrific !!!

Please, please keep us updated on how you're doing on Abilify .... a lot of people will want to know and to cheer you on in the Grand Experiment !!!

 

[SueJohnPat]

That's terrific !!!

Please, please keep us updated on how you're doing on Abilify .... a lot of people will want to know and to cheer you on in the Grand Experiment !!!

Thank you I will.

 

[SueJohnPat]

Great news. What dose are you taking and how long?

I am taking 2.5 mg daily at bedtime ( mostly) . One day I forgot and switched it to the am . No adverse effects.